EFFICACY OF ATROPINE EYE DROPS AS THERAPY OF PROGRESSIVE MYOPIA IN CHILDREN : A SYSTEMATIC REVIEW
Main Article Content
Keywords
atropine, childhood myopia, efficacy, progressive myopia
Abstract
Objective: This review was carried out to determine the efficient concentration of atropine eye drops in inhibiting the progression of myopia in children.
Materials & Methods: A literature search was conducted across databases such as PubMed, ScienceDirect, SpringerLink, and ProQuest, using search terms such as "myopia progression","myopia", and "atropine". The evaluation of efficacy was based on Corrected Visual Acuity, axial length, and adverse effects.
Results: The study included data from 12 Randomized Controlled Trials (RCTs) comprising3,651 participants exposed to seven atropine concentrations, including 1%, 0.5%, 0.1%, 0.05%, 0.02%, 0.025% and 0.01%. The results showed that higher atropine doses were more effective in slowing myopia progression.
Conclusion: Very Low Dose Atropine eye drops have proven to be sufficiently efficacious in decelerating the progression of myopia in pediatric patients, showing minimal side and rebound effects.
References
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(17)Zhu, Q.; Tang, Y.; Guo, L.; Tighe, S.; Zhou, Y.; Zhang, X.; Zhang, J.; Zhu, Y.; Hu, M. Efficacy and Safety of 1% Atropine on Retardation of Moderate Myopia Progression in Chinese School Children. Int. J. Med. Sci.2020, 17 (2), 176–181. https://doi.org/10.7150/ijms.39365.
(18)Wei, S.; Li, S.-M.; An, W.; Du, J.; Liang, X.; Sun, Y.; Zhang, D.; Tian, J.; Wang, N. Safety and Efficacy of Low-Dose Atropine Eyedrops for the Treatment of Myopia Progression in Chinese Children: A Randomized Clinical Trial. JAMA Ophthalmol2020, 138 (11), 1178–1184. https://doi.org/10.1001/jamaophthalmol.2020.3820.
(19)The ATOM-J. Study Group; Hieda, O.; Hiraoka, T.; Fujikado, T.; Ishiko, S.; Hasebe, S.; Torii, H.; Takahashi, H.; Nakamura, Y.; Sotozono, C.; Oshika, T.; Morimoto, T.; Nishida, K.; Nishikawa, N.; Song, Y.-S.; Tokutake, T.; Nishi, Y.; Shigeno, Y.; Kurihara, T.; Negishi, K.; Tsubota, K.; Ono, M.; Nakai, T.; Tan, D.; Tanaka, S.; Kinoshita, S. Efficacy and Safety of 0.01% Atropine for Prevention of Childhood Myopia in a 2-Year Randomized Placebo-Controlled Study. Jpn J Ophthalmol2021, 65 (3), 315–325. https://doi.org/10.1007/s10384-021-00822-y.
(20)Saxena, R.; Dhiman, R.; Gupta, V.; Kumar, P.; Matalia, J.; Roy, L.; Swaminathan, M.; Phuljhele, S.; Velpandian, T.; Sharma, N. Atropine for the Treatment of Childhood Myopia in India: Multicentric Randomized Trial. Ophthalmology2021, 128 (9), 1367–1369. https://doi.org/10.1016/j.ophtha.2021.01.026.
(21)Zhao, Q.; Hao, Q. Clinical Efficacy of 0.01% Atropine in Retarding the Progression of Myopia in Children. Int Ophthalmol2021, 41 (3), 1011–1017. https://doi.org/10.1007/s10792-020-01658-0.
(22)Cui, C.; Li, X.; Lyu, Y.; Wei, L.; Zhao, B.; Yu, S.; Rong, J.; Bai, Y.; Fu, A. Safety and Efficacy of 0.02% and 0.01% Atropine on Controlling Myopia Progression: A 2-Year Clinical Trial. Sci Rep2021, 11 (1), 22267. https://doi.org/10.1038/s41598-021-01708-2.
(23)Chaurasia, S.; Negi, S.; Kumar, A.; Raj, S.; Kaushik, S.; Optom, R. K. M.; Kishore, P.; Dogra, M. R. Efficacy of 0.01% Low Dose Atropine and Its Correlation with Various Factors in Myopia Control in the Indian Population. Sci Rep2022, 12 (1), 7113. https://doi.org/10.1038/s41598-022-10079-1.
(24)Ye, L.; Xu, H.; Shi, Y.; Yin, Y.; Yu, T.; Peng, Y.; Li, S.; He, J.; Zhu, J.; Xu, X. Efficacy and Safety of Consecutive Use of 1% and 0.01% Atropine for Myopia Control in Chinese Children: The Atropine for Children and Adolescent Myopia Progression Study. Ophthalmol Ther2022, 11 (6), 2197–2210. https://doi.org/10.1007/s40123-022-00572-1.
(25)Walline, J.; Smith, M. Controlling Myopia Progression in Children and Adolescents. AHMT2015, 133. https://doi.org/10.2147/AHMT.S55834.
(26)Ha, A.; Kim, S. J.; Shim, S. R.; Kim, Y. K.; Jung, J. H. Efficacy and Safety of 8 Atropine Concentrations for Myopia Control in Children. Ophthalmology2022, 129 (3), 322–333. https://doi.org/10.1016/j.ophtha.2021.10.016.
(27)Zhao, Y. Atropine 0.01% Eye Drops Slow Myopia Progression: A Systematic Review and Meta-Analysis. Int J Ophthalmol2019, 12 (8), 1337–1343. https://doi.org/10.18240/ijo.2019.08.16.
(28)Prousali, E.; Haidich, A.-B.; Fontalis, A.; Ziakas, N.; Brazitikos, P.; Mataftsi, A. Efficacy and Safety of Interventions to Control Myopia Progression in Children: An Overview of Systematic Reviews and Meta-Analyses. BMC Ophthalmol2019, 19 (1), 106. https://doi.org/10.1186/s12886-019-1112-3.
(2)He, M.; Xiang, F.; Zeng, Y.; Mai, J.; Chen, Q.; Zhang, J.; Smith, W.; Rose, K.; Morgan, I. G. Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial. JAMA2015, 314 (11), 1142. https://doi.org/10.1001/jama.2015.10803.
(3)Lingham, G.; Mackey, D. A.; Lucas, R.; Yazar, S. How Does Spending Time Outdoors Protect against Myopia? A Review. Br J Ophthalmol2020, 104 (5), 593–599. https://doi.org/10.1136/bjophthalmol-2019-314675.
(4)Wen, L.; Cao, Y.; Cheng, Q.; Li, X.; Pan, L.; Li, L.; Zhu, H.; Lan, W.; Yang, Z. Objectively Measured near Work, Outdoor Exposure and Myopia in Children. Br J Ophthalmol2020, bjophthalmol-2019-315258. https://doi.org/10.1136/bjophthalmol-2019-315258.
(5)Wang, J.; Li, Y.; Musch, D. C.; Wei, N.; Qi, X.; Ding, G.; Li, X.; Li, J.; Song, L.; Zhang, Y.; Ning, Y.; Zeng, X.; Hua, N.; Li, S.; Qian, X. Progression of Myopia in School-Aged Children After COVID-19 Home Confinement. JAMA Ophthalmol2021, 139 (3), 293. https://doi.org/10.1001/jamaophthalmol.2020.6239.
(6)RANZCO-Position-Statement-Progressive-Myopia-in-Childhood_2022.Pdf.
(7)Sacchi, M.; Serafino, M.; Villani, E.; Tagliabue, E.; Luccarelli, S.; Bonsignore, F.; Nucci, P. Efficacy of Atropine 0.01% for the Treatment of Childhood Myopia in European Patients. Acta Ophthalmol2019, 97 (8). https://doi.org/10.1111/aos.14166.
(8)WHO Report Myopia 2016.Pdf.
(9)Jinabhai, A. N.; Feaoo, Mco. F. F.; Glover, M. How Effective Are Atropine Eye Drops at Reducing Myopia Progression in Children? Optometry in Practice2019, 20 (3), 18.
(10)Upadhyay, A.; Beuerman, R. W. Biological Mechanisms of Atropine Control of Myopia. Eye & Contact Lens: Science & Clinical Practice2020, 46 (3), 129–135. https://doi.org/10.1097/ICL.0000000000000677.
(11)Sathyan, S. Atropine in the Treatment of Childhood Myopia. Kerala J Ophthalmol2019, 31 (1), 4. https://doi.org/10.4103/kjo.kjo_6_19.
(12)Chen, C.; Yao, J. Efficacy and Adverse Effects of Atropine for Myopia Control in Children: A Meta-Analysis of Randomised Controlled Trials. Journal of Ophthalmology2021, 2021, 1–12. https://doi.org/10.1155/2021/4274572.
(13)Chia, A.; Chua, W.-H.; Cheung, Y.-B.; Wong, W.-L.; Lingham, A.; Fong, A.; Tan, D. Atropine for the Treatment of Childhood Myopia: Safety and Efficacy of 0.5%, 0.1%, and 0.01% Doses (Atropine for the Treatment of Myopia 2). Ophthalmology2012, 119 (2), 347–354. https://doi.org/10.1016/j.ophtha.2011.07.031.
(14)Yi, S.; Huang, Y.; Yu, S.-Z.; Chen, X.-J.; Yi, H.; Zeng, X.-L. Therapeutic Effect of Atropine 1% in Children with Low Myopia. Journal of American Association for Pediatric Ophthalmology and Strabismus2015, 19 (5), 426–429. https://doi.org/10.1016/j.jaapos.2015.04.006.
(15)Wang, Y.-R.; Bian, H.-L.; Wang, Q. Atropine 0.5% Eyedrops for the Treatment of Children with Low Myopia: A Randomized Controlled Trial. Medicine (Baltimore)2017, 96 (27), e7371. https://doi.org/10.1097/MD.0000000000007371.
(16)Yam, J. C.; Jiang, Y.; Tang, S. M.; Law, A. K.; Chan, J. J.; Wong, E.; Ko, S. T.; Young, A. L.; Tham, C. C.; Chen, L. J.; others. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology2019, 126 (1), 113–124.
(17)Zhu, Q.; Tang, Y.; Guo, L.; Tighe, S.; Zhou, Y.; Zhang, X.; Zhang, J.; Zhu, Y.; Hu, M. Efficacy and Safety of 1% Atropine on Retardation of Moderate Myopia Progression in Chinese School Children. Int. J. Med. Sci.2020, 17 (2), 176–181. https://doi.org/10.7150/ijms.39365.
(18)Wei, S.; Li, S.-M.; An, W.; Du, J.; Liang, X.; Sun, Y.; Zhang, D.; Tian, J.; Wang, N. Safety and Efficacy of Low-Dose Atropine Eyedrops for the Treatment of Myopia Progression in Chinese Children: A Randomized Clinical Trial. JAMA Ophthalmol2020, 138 (11), 1178–1184. https://doi.org/10.1001/jamaophthalmol.2020.3820.
(19)The ATOM-J. Study Group; Hieda, O.; Hiraoka, T.; Fujikado, T.; Ishiko, S.; Hasebe, S.; Torii, H.; Takahashi, H.; Nakamura, Y.; Sotozono, C.; Oshika, T.; Morimoto, T.; Nishida, K.; Nishikawa, N.; Song, Y.-S.; Tokutake, T.; Nishi, Y.; Shigeno, Y.; Kurihara, T.; Negishi, K.; Tsubota, K.; Ono, M.; Nakai, T.; Tan, D.; Tanaka, S.; Kinoshita, S. Efficacy and Safety of 0.01% Atropine for Prevention of Childhood Myopia in a 2-Year Randomized Placebo-Controlled Study. Jpn J Ophthalmol2021, 65 (3), 315–325. https://doi.org/10.1007/s10384-021-00822-y.
(20)Saxena, R.; Dhiman, R.; Gupta, V.; Kumar, P.; Matalia, J.; Roy, L.; Swaminathan, M.; Phuljhele, S.; Velpandian, T.; Sharma, N. Atropine for the Treatment of Childhood Myopia in India: Multicentric Randomized Trial. Ophthalmology2021, 128 (9), 1367–1369. https://doi.org/10.1016/j.ophtha.2021.01.026.
(21)Zhao, Q.; Hao, Q. Clinical Efficacy of 0.01% Atropine in Retarding the Progression of Myopia in Children. Int Ophthalmol2021, 41 (3), 1011–1017. https://doi.org/10.1007/s10792-020-01658-0.
(22)Cui, C.; Li, X.; Lyu, Y.; Wei, L.; Zhao, B.; Yu, S.; Rong, J.; Bai, Y.; Fu, A. Safety and Efficacy of 0.02% and 0.01% Atropine on Controlling Myopia Progression: A 2-Year Clinical Trial. Sci Rep2021, 11 (1), 22267. https://doi.org/10.1038/s41598-021-01708-2.
(23)Chaurasia, S.; Negi, S.; Kumar, A.; Raj, S.; Kaushik, S.; Optom, R. K. M.; Kishore, P.; Dogra, M. R. Efficacy of 0.01% Low Dose Atropine and Its Correlation with Various Factors in Myopia Control in the Indian Population. Sci Rep2022, 12 (1), 7113. https://doi.org/10.1038/s41598-022-10079-1.
(24)Ye, L.; Xu, H.; Shi, Y.; Yin, Y.; Yu, T.; Peng, Y.; Li, S.; He, J.; Zhu, J.; Xu, X. Efficacy and Safety of Consecutive Use of 1% and 0.01% Atropine for Myopia Control in Chinese Children: The Atropine for Children and Adolescent Myopia Progression Study. Ophthalmol Ther2022, 11 (6), 2197–2210. https://doi.org/10.1007/s40123-022-00572-1.
(25)Walline, J.; Smith, M. Controlling Myopia Progression in Children and Adolescents. AHMT2015, 133. https://doi.org/10.2147/AHMT.S55834.
(26)Ha, A.; Kim, S. J.; Shim, S. R.; Kim, Y. K.; Jung, J. H. Efficacy and Safety of 8 Atropine Concentrations for Myopia Control in Children. Ophthalmology2022, 129 (3), 322–333. https://doi.org/10.1016/j.ophtha.2021.10.016.
(27)Zhao, Y. Atropine 0.01% Eye Drops Slow Myopia Progression: A Systematic Review and Meta-Analysis. Int J Ophthalmol2019, 12 (8), 1337–1343. https://doi.org/10.18240/ijo.2019.08.16.
(28)Prousali, E.; Haidich, A.-B.; Fontalis, A.; Ziakas, N.; Brazitikos, P.; Mataftsi, A. Efficacy and Safety of Interventions to Control Myopia Progression in Children: An Overview of Systematic Reviews and Meta-Analyses. BMC Ophthalmol2019, 19 (1), 106. https://doi.org/10.1186/s12886-019-1112-3.
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Jan 12, 2024
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Ika Puspita, Marlyanti Nur Rahmah, Ratih Natasha Maharani, Rani Yunita Patong, & Muhammad Irfan Kamaruddin. (2024). EFFICACY OF ATROPINE EYE DROPS AS THERAPY OF PROGRESSIVE MYOPIA IN CHILDREN : A SYSTEMATIC REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 31(1), 374–381. https://doi.org/10.53555/jptcp.v31i1.3911
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Author Biographies
Ika Puspita
Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Marlyanti Nur Rahmah
Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Ratih Natasha Maharani
Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Rani Yunita Patong
Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Muhammad Irfan Kamaruddin
Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia